Here is my presentation

Occupational therapy-technologies for learning from habuchanan

Reflection 4: Description of the intervention

Feedback on my reflection from last week: 

I found out that other affordances of blogs include:

·        Giving students opportunities for discovery through videos and other learning materials;

·        Opportunities for self-directed learning;

·        Developing skills in critical review of learning materials;

·        The possibility of incorporating group work – this is something that I could consider incorporating either as part of the existing tutorials or as a mini-project students could work on at the various placements.

Rita’s feedback on my blog was that posting the YouTube videos on to a blog may be a good starting point but that I should design a task that will facilitate peer support and learning. I am a bit stumped on what tasks I could devise but hoping to have a revelation overnight …

The intervention:

A blog will be created with a link from the existing LMS. The blog will include YouTube videos and other resources demonstrating specific skills that students require in their ‘physical health’ practice learning placements. The blog will enable students to access the information they need when it is most needed. Students will be expected to comment on the usefulness of the materials posted and their reflections on these materials. They will also be invited to add additional resources that they have located and that may be helpful to other students. This also applies to the other lecturers and clinical educators involved in this course. Although a formalised mark will not be given to student’s participation on the blog, lecturers and clinical educators could consider commenting on student participation in their practice learning evaluations. The blog will be set up by the end of the week and students will be invited to access the site and give feedback. Lecturers and clinical educators will also be asked to visit the site and give feedback.

Reflection 3: Established practice & affordances

In our last face-to-face discussion, I realised that I needed to change my project slightly. The need that emerged from the survey responses from students and lecturers identified a need for video clips and resources that showed application of interventions. Students indicated that they needed to have resources available when they needed them, rather than relying on their formalised lectures and practicals. Therefore, the outcome for this case study has been revised as follows:

To introduce an appropriate technology to support and advance student learning in applying 'physical health' modalities. The technology should be accessible to students when they need it, particularly during their physical health practice learning placements and should supplement the existing LMS.

The challenge is to find relevant resources, such as YouTube clips, that will demonstrate how to apply relevant occupational therapy methods and techniques. These resources must be available to students at the point that they need it.

Literature review

An Irish occupational therapy study involving undergraduate students completing their practice placements showed that blogs were not effective for developing reflection or clinical reasoning, but were beneficial for peer support and learning (Wiid et al, 2013). In this study, students were placed at large distances from the university and each other. The study suggests that blogs are useful for peer support and learning during practice learning. Thus, a blog seems to be effective for meeting achieving the outcome noted above. 

Established practice

Currently, students are taught the knowledge and skills needed for practice learning before entering their first placement, or as it 'fits in to the timetable'. Half the class complete their 'physical health' placements during the first semester while the other half do so in the second semester. Some modalities have either not been covered or may not have been completely covered before the first placements. Students doing their physical health block in the first semester may therefore not be equipped with all the skills needed to effectively. Students doing their placements in the 2nd semester may have forgotten the modalities by the time they go into their physical health placements. Currently, students have to go through their notes on their own or they may go to the skills lab to practice the skills they need as they are required. There are currently no online resources for students to access after formal teaching hours. Students have to rely on their notes or text books which are not adequate for them to revise skills. The consequence is that either clients are given treatment that is 'second best' or clinicians and supervisors have to spend additional time revising the skills with the student. Video clips from YouTube or other sources would be a valuable addition in that students could refresh their memories on specific skills at the point they need the skills. The current LMS does not provide a facility for posting URLs of relevant YouTube videos and for students and staff to comment on them. It also does not easily allow students to add resources they find and that may be beneficial to others in the class.

Impact / affordances of emerging technologies

Blogs are a convenient method of sharing information. They allow people with little technical knowledge to publish their thoughts, opinions and information online relatively easily (Deng & Yuen, 2011).  

Deng and Yuen (2011) developed a framework for the educational affordances of blogs. These affordances were linked with three major types of blogging behaviour, namely writing, reading and commenting, and spanned individual and community dimensions. Affordances were:

• self-reflection

• self-expression

• reflection triggered by reading

• Social connection

• Reflective dialogue

• Social interaction.

Blogs may enable occupational therapy students to share their experiences of applying specific modalities during their practice learning placements as well as offer an outlet for emotional expression. Blogs used for non-evaluative purposes allow free, spontaneous writing during which students may share their ups and downs during practice learning (Deng & Yuen, 2011). Blogs can assist students to develop a range of cognitive, social and self-directed learning skill (Robertson, 2011). Considering that the outcome of this case study is related to self-directed learning, a blog is a suitable technology to meet the need identified in the occupational therapy course.

Facebook  was a possible alternative, however files in formats other than pictures or videos cannot be posted on Facebook (Wang et al, 2012). Therefore it is not suitable to meet the needs outlined in this case study. 

References

Deng L, Yuen A (2011). Towards a framework for educational affordances of blogs. Computers & Education, 56, 441-451.

Robertson J (2011). The educational affordances of blogs for self-directed learning. Computers & Education, 57: 1628-1644.

Wang Q, Woo H, Quek C, Yang Y, Liu M (2012). Using the Facebook group as a learning management system: an exploratory study. British Journal of Educational Technology, 43(3): 428-438.

Wiid C, McCormack C, Warren A, Buckley S, Cahill M (2013). Public and private blogging during placements: perspectives of occupational therapy students. International Journal of Therapy and Rehabilitation 20(2): 79-85.

Reflection 2: Literature review

Analysis of responses from the two surveys so far:

Survey to find out current use and suggestions about additional tools in the LMS for the 'Occupational Therapy in Physical Health' course

	Lecturers (n=4)	Students (n=4)
Current tools used
Announcements	4	4
Resources	4	3
Calendar	1	0
Assignments	1	0
Course evaluation	1	2
Gradebook	0	3
Suggested tool to support learning during practice learning placements	·        Video resources for students to refer to ·        Submitting written work (client treatment logs, reflective logs and case studies) via Assignment tab à maintain a record of student submissions and turnaround time for supervisor feedback ·        Specific tab for practice learning that includes assessment forms and checklists ·        Chat rooms for teaching staff to assist students as problems arise ·        Tests and quizzes	·        YouTube videos to help practice ·        Resources on the practical implementation of intervention techniques

Of the students who responded, 2 used the LMS 3 times a week, 1 less than 3 times a week and 1 hardly ever. Most accessed announcements from Vula via their cell phones. 

The number of student responses is somewhat disappointing, but not unexpected.

Summary

Students want videos and resources to assist them with practical application of OT intervention methods. Lecturers support this but have made additional practical suggestions for othre tools that could support the students when they are in practice learning, i.e. quizzes, chat rooms, submission of written work online and a resource to access assessment forms.

Literature review to inform the intervention

A search of EBSCO host (ERIC, CINAHL, Health Source: Nursing and Allied Health Edition and Africa-Wide were selected) using the keywords ‘occupational therapy’, ‘clinical reasoning’ ‘e-learning’, ‘learning management systems’ and ‘online learning’, revealed 5 relevant articles of which 2 were not yet available through the UCT library (1 year embargo). This is clearly an under-researched area in occupational therapy.

Main points identified

• A review of the potential of computer-enhanced classroom-based teaching and online professional education showed that students appreciated the increased access, greater variety and convenience offered by online materials and the fact that they could pace their learning but that it required reliable technology (Hollis and Madill, 2006). From the lecturers’ perspectives, online education enabled effective and efficient communication with students but demanded additional preparation time and appropriate training and support (Hollis and Madill, 2006).
• Development of professional expertise requires contextualised learning as well as reflective judgement during and/or after the learning experience so that students can link theory with actions (Schell and Schell, 2008). Reflection in and on action enables students to apply information in real practice situations (Schell and Schell, 2008).
• Written case scenarios and reflective journals can be effective in facilitating the development of clinical reasoning as shown in a group of Masters of Occupational Therapy students in America (Mitchell and Batorski, 2006). It is, however, preferable to have transcripts of actual interviews with clients, family members and/or team members when using paper cases (Mitchell and Batorski, 2006). Students need guidance during learning and should be provided with individual feedback (Mitchell and Batorksi, 2006).
• More research is needed to identify the most effective methods for assisting novices to learn how to make expert decision about their clients (Mitchell and Batorski, 2006).
• An inter-professional course for health sciences students including occupational therapists compared a 100% face-to-face delivery format with a blended learning format  (70% instruction via a synchronous virtual classroom technology (Elluminate) and 30% with an asynchronous technology (WebCT)) and found equivalent effects in team process skills but  a more positive experience of learning in the blended format group (Carbonaro et al, 2008).
• Example of how case studies can be developed into scenarios to encourage clinical reasoning using a 6-step process (Levett-Jones and Hoffmann).

Conclusion

1. A LMS allows students to access course materials when they need it and facilitates communication between lecturers and students.
2. Students in this course already write reflections on practice but perhaps these could be submitted and commented on via the LMS.
3. A LMS can be used to develop clinical reasoning provided the appropriate materials are developed.

References

Carbonaro M, King S, Taylor E, Satzinger F, Snart F, Drummond J (2008). Integration of e-learning technologies in an interprofessional health sciences course. Medical Teacher, 30: 25-33.

Hollis V, Madill H (2006). Online learning : the potential for occupational therapy education. Occupational Therapy International, 13(2): 61-68.

Levett-Jones T, Hoffmann K (no date). Turning case studies into online clinical reasoning scenarios using a set of generic design principles. Australian Learning and Teaching Council project team.

Mitchell A, Batorski R (2009). A study of critical reasoning in online learning: application of the occupational performance process model. Occupational Therapy International, 16(2): 134-153.

Schell B, Schell J (eds) (2008). Clinical and professsional reasoning in occupational therapy. Philadelphia: Lippincott, Williams & Wilkins.

Surveys on our LMS

I developed 2 surveys to identify current use of our LMS (Vula) and how it could be developed further:

1. Student survey - available at:
https://docs.google.com/forms/d/1xMeyi6TwvuMnwM261CSmjDGed7Gwyve11bslhahJ4dg/edit
2. Lecturer survey - available at:
https://docs.google.com/forms/d/1z4ebxUdp4kA7_aZJSuxDGp8S65i4DNJ_KgCeKFrzXkw/viewform

Reflection 1: Background, intended outcomes and challenges

Background:
I teach on a 3rd year occupational therapy course at the University of Cape Town titled 'Occupational Therapy in Physical Health conditions'. There are 3 other lecturers who teach on this course and there are 48 students registered. Students vary in their learning styles and capabilities. Teaching occurs through lecture, tutorials, practicals and practice learning. Students are required to prepare for lectures by completing readings and/or tasks prepared by the lecturer concerned. The learning management system (LMS) for the course is used mainly to communicate with students (posting messages) and to post resources such as notes, Powper Point presentations or articles. Students have Wednesday afternoons free  for self-directed learning. During practice learning blocks (these are periods during which students are placed with a qualified occupational therapist) students are expected to work with patients in different settings (hospitals, community health centres or rehabilitation facilities) in order to learn how to apply their knowledge and skills in practice.

Intended outcome(s):  
To introduce appropriate technologies in the existing LMS that will support and advance learning and clinical reasoning during practice learning.

Challenges:
There are currently no technologies in place to support and facilitate the development of clinical reasoning during 3rd year physical health practice learning. Clinical reasoning is a critical aspect of students' process of becoming competent occupational therapist which is currently fostered through one-on-one discussion with clinical supervisors and/or occupational therapy clinicians. It is therefore interesting that we have not explored the possibilities of using technology/ies to create additional opportunities for this. These may also be less time-intensive, less threatening and more fun than individual supervision sessions.